The female gubernaculum: role in the embryology and development of the genital tract and in the possible genesis of malformations

作者：Acien Pedro^*; Sanchez del Campo Francisco; Mayol Maria Jose; Acien Maribel

来源：European Journal of Obstetrics & Gynecology and Reproductive Biology, 2011, 159(2): 426-432.

DOI：10.1016/j.ejogrb.2011.07.040

• Gubernaculum
• Female genital tract
• Malformations
• Mullerian ducts
• Uterus
• Round ligament
• Rokitansky syndrome
• Accessory uterine masses

The female gubernaculum is an embryonic structure that gives rise to the uterine round ligament and seems to be important in Mullerian development. In the absence of androgens and anti-Mullerian hormone, the paramesonephric or Mullerian ducts complete their invagination and development, interfering with the connection of the tissue column that begins at the inguinal cone (the gubernaculum) and targets the mesonephric duct and caudal ligament of the gonad. The gubernaculum then grows over the Mullerian ducts, incorporating its muscular fibres. Outside and above this point, the Mullerian ducts give rise to the Fallopian tubes, whereas medially to the point of insertion of the gubernaculum, the Mullerian ducts develop into the normal uterus, the adequate formation of which is also induced by the mesonephric ducts. Diverse human anatomical and physiological characteristics such as the simplex uterus, as well as pathological conditions and certain female genital malformations, could be related to gubernaculum dysfunction.
The main conclusions in this article are: (1) The female gubernaculum is the origin of the uterine round ligament but probably not of the uteroovarian ligament. Gubernacula are composed of muscular fibres that probably derive from the abdominal wall and that, when fixed and fused with the Mullerian ducts, allow or induce, together with the mesonephric ducts, the adequate development and formation of the uterus. (2) The female gubernaculum seems to be responsible for many of the specific human characteristics of Mullerian development, including the uterus simplex, the anteflexion and low intra-abdominal position of the uterus, and the disposition of uterine muscular fibres. (3) The female gubernaculum seems to be related to pathologies arising from the round ligaments and inguinal hernia. Likewise, certain uterine malformations (e.g., didelphys uterus, Rokitansky syndrome) and accessory and cavitated uterine masses might be related to gubernaculum dysfunction.

• 出版日期2011-12